Essentials of Anatomy and Physiology

Copyright © 2007 by F. A. Davis.

Copyright © 2007 by F. A. Davis.

List of Boxes

Clinical applications of the book’s anatomical and physiological information are set
apart from the text in boxed inserts and often deal with aspects of pathophysiology. A
list of these boxes is presented here for your convenience.

1-1 Replacing Tissues and Organs, 6
1-2 Visualizing the Interior of the Body, 18
2-1 Blood Gases, 30
2-2 Nitric Oxide, 31
2-3 Lipids in the Blood, 36
2-4 A Protein Mystery: Prions, 39
3-1 Terminology of Solutions, 53
3-2 Genetic Disease – Sickle-Cell Anemia, 59
3-3 Abnormal Cellular Functioning – Cancer, 61
4-1 Cystic Fibrosis, 74
4-2 Vitamin C and Collagen, 78
4-3 Cosmetic Collagen, 78
5-1 Burns, 92–93
5-2 Preventing Skin Cancer: Common Sense and Sunscreens, 94
5-3 Common Skin Disorders, 97
5-4 Administering Medications, 100
6-1 Fractures and Their Repair, 111
6-2 Osteoporosis, 113
6-3 Herniated Disc, 121
6-4 Abnormalities of the Curves of the Spine, 122
6-5 Arthritis, 130
7-1 Anabolic Steroids, 141
7-2 Tetanus and Botulism, 146
7-3 Muscular Dystrophy, 148
7-4 Myasthenia Gravis, 148
7-5 Common Injection Sites, 149
8-1 Multiple Sclerosis, 168
8-2 Shingles, 174
8-3 Spinal Cord Injuries, 176
8-4 Cerebrovascular Accidents, 181
8-5 Aphasia, 182
8-6 Alzheimer’s Disease, 183
8-7 Parkinson’s Disease, 184
8-8 Lumbar Puncture, 187
9-1 Cataracts, 205
9-2 Glaucoma, 207
9-3 Errors of Refraction, 208
9-4 Night Blindness and Color Blindness, 209
9-5 Deafness, 214
9-6 Motion Sickness, 216
10-1 Disorders of Growth Hormone, 230
10-2 Disorders of Thyroxine, 235
10-3 Diabetes Mellitus, 238
10-4 Disorders of the Adrenal Cortex, 242
11-1 Anemia, 257
11-2 Jaundice, 259
11-3 Rh Disease of the Newborn, 261
11-4 Leukemia, 263
11-5 White Blood Cell Types: HLA, 264
11-6 Hemophilia, 266
11-7 Dissolving Clots, 268
12-1 Coronary Artery Disease, 280

(List of boxes continued on inside back cover)

Copyright © 2007 by F. A. Davis.

Copyright © 2007 by F. A. Davis.

Copyright © 2007 by F. A. Davis.

Valerie C. Scanlon, PhD

College of Mount Saint Vincent
Riverdale, New York

Tina Sanders

Medical Illustrator
Castle Creek, New York
Formerly
Head Graphic Artist
Tompkins Cortland Community College
Dryden, New York

Copyright © 2007 by F. A. Davis.

F. A. Davis Company
1915 Arch Street
Philadelphia, PA 19103
www.fadavis.com

Copyright © 2007 by F. A. Davis Company

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Printed in the United States of America

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Nursing Editor: Lisa B. Deitch
Developmental Editor: Alan Sorkowitz
Project Editor: Ilysa H. Richman
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Library of Congress Cataloging-in-Publication Data

Scanlon, Valerie C.,

Essentials of anatomy and physiology/ Valerie C. Scanlon, Tina

Sanders. — 5th ed.

p. ; cm.

Includes index.

ISBN–13: 978-0-8036-1546-5 ISBN–10: 0-8036-1546-9

1. Human anatomy. 2. Human physiology. I. Sanders, Tina,

1943-. II. Title. III. Title: Anatomy and physiology.

[DNLM: 1. Anatomy. 2. Physiology. QS 4 S283e 2006]

QP34.5.S288 2006

612—dc22 2006015120

Authorization to photocopy items for internal or personal use, or the internal or personal
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Copyright Clearance Center (CCC) Transactional Reporting Service, provided that the
fee of $.10 per copy is paid directly to CCC, 222 Rosewood Drive, Danvers, MA 01923.
For those organizations that have been granted a photocopy license by CCC, a separate
system of payment has been arranged. The fee code for users of the Transactional
Reporting Service is: 8036-1546/07 0 ϩ $.10.

Copyright © 2007 by F. A. Davis.

Preface

A fifth edition of Essentials of Anatomy and Physiology is very gratifying, and again we

have the pleasure of thanking all of our colleagues in teaching who continue to use our
textbook and of welcoming new teachers and students.

Changes have been made in the content of the book to keep the material as current
as possible. Most of these are small changes, such as a new cell organelle, the protea-
some, in Chapter 3; a clarification of blood cell production in Chapters 4, 11, and 14;
and the addition of concentric and eccentric contractions to Chapter 7. The most
extensive revision is in Chapter 14: The section on immunity has been rewritten using
the categories of innate and adaptive immunity.

New illustrations in this edition include positive and negative feedback mecha-
nisms in Chapter 1, cellular transport mechanisms in Chapter 3, hormones that affect
blood pressure in Chapter 13, innate immunity in Chapter 14, and synthesis uses of
foods in Chapter 17. Illustrations that have been revised include protein structure,
active site theory, and DNA and RNA structure in Chapter 2, blood cells in Chapter
11, and adaptive immunity in Chapter 14.

Also new to this edition are illustration questions. Each figure legend is followed
by a question for the student; the answers are in Appendix G.

As always, your comments and suggestions will be most welcome, and they may be
sent to us in care of the publisher: F. A. Davis Company, 1915 Arch Street,
Philadelphia, PA 19103.
Valerie C. Scanlon
Dobbs Ferry, New York
Tina Sanders
Castle Creek, New York

v

Copyright © 2007 by F. A. Davis.

To the Instructor

A s the science and arts of medicine and health care become increasingly complex,

so too does the education of those who pursue careers in nursing and other health-
related fields. Human anatomy and physiology is often a first course in many educa-
tion programs, and is the basis for so many of the more specialized courses. Teachers
of introductory anatomy and physiology thus take on a special challenge: We must
distill and express the complexities of human structure and function in a simple way,
without losing the essence and meaning of the material. That is the goal of this text-
book: to make this material readily accessible to students with diverse backgrounds
and varying levels of educational preparation.

No prior knowledge of biology or chemistry is assumed, and even the most funda-
mental terms are defined thoroughly. Essential aspects of anatomy are presented
clearly and reinforced with excellent illustrations. Essential aspects of physiology are
discussed simply, yet with accuracy and precision. Again, the illustrations complement
the text material and foster comprehension on the part of the student. These illustra-
tions were prepared especially for students for whom this is a first course in anatomy
and physiology. As you will see, these are images in which detail is readily apparent.
All important parts have been labeled, but the student is not overwhelmed with
unnecessary labels. Illustrations of physiology lead the student step-by-step.
Wherever appropriate, the legends refer students to the text for further description or
explanation. Each illustration also has a question for the student; the illustration ques-
tions in a chapter form an ongoing self-test. (The answers are given in Appendix G.)

The text has three unifying themes: the relationship between physiology and
anatomy, the interrelations among the organ systems, and the relationship of each
organ system to homeostasis. Although each type of cell, tissue, organ, or organ sys-
tem is discussed simply and thoroughly in itself, applicable connections are made to
other aspects of the body or to the functioning of the body as a whole. Our goal is to
provide your students with the essentials of anatomy and physiology, and in doing so,
to help give them a solid foundation for their future work, and an appreciation for the
incredible living organism that is the human body.

The sequence of chapters is a very traditional one. Cross-references are used to
remind students of what they have learned from previous chapters. Nevertheless, the
textbook is very flexible, and, following the introductory four chapters, the organ sys-
tems may be covered in almost any order, depending on the needs of your course.

Each chapter is organized from the simple to the more complex, with the anatomy
followed by the physiology. The Instructor’s Guide presents modifications of the topic
sequences that may be used, again depending on the needs of your course. Certain
more advanced topics may be omitted from each chapter without losing the meaning
or flow of the rest of the material, and these are indicated, for each chapter, in the
Instructor’s Guide.

Clinical applications are set apart from the text in boxed inserts. These are often
aspects of pathophysiology that are related to the normal anatomy or physiology in the
text discussion. Each box presents one particular topic and is referenced at the appro-
priate point in the text. This material is intended to be an integral part of the chapter

vi

Copyright © 2007 by F. A. Davis.

To the Instructor vii

but is set apart for ease of reference and to enable you to include or omit as many of
these topics as you wish. The use of these boxes also enables students to read the text
material without interruption and then to focus on specific aspects of pathophysiology.
A comprehensive list of the boxes appears inside the book’s front and back covers, and
another list at the beginning of each chapter cites the boxes within that chapter.

Tables are utilized as summaries of structure and function, to present a sequence of
events, or additional material that you may choose to include. Each table is referenced
in the text and is intended to facilitate your teaching and to help your students learn.

New terms appear in bold type within the text, and all such terms are fully defined
in an extensive glossary, with phonetic pronunciations. Bold type may also be used for
emphasis whenever one of these terms is used again in a later chapter.

Each chapter begins with a chapter outline and student objectives to prepare the
student for the chapter itself. New terminology and related clinical terms are also
listed, with phonetic pronunciations. Each of these terms is fully defined in the glos-
sary, with cross-references back to the chapter in which the term is introduced.

At the end of each chapter are a study outline and review questions. The study out-
line includes all of the essentials of the chapter in a concise outline form. The review
questions may be assigned as homework, or used by the students as a review or self-
test. Following each question is a page reference in parentheses. This reference cites
the page(s) in the chapter on which the content needed to answer the question cor-
rectly can be found. The answers themselves are included in the Instructor’s Guide.
The questions in the sections titled For Further Thought may be used in a variety of
ways, and the answers are in the Instructor’s Guide.

An important supplementary learning tool for your students is available in the form
of a Student Workbook that accompanies this text. For each chapter in the textbook, the
workbook offers fill-in and matching-column questions, figure-labeling and figure-
coloring exercises, and crossword puzzles based on the chapter’s vocabulary list. Also
included are two comprehensive, multiple-choice chapter tests to provide a thorough
review. All answers are provided at the end of the workbook.

Ancillary materials for the teacher using this text are all on a CD-ROM: a complete
Instructor’s Guide, two computerized test banks, and an Image Ancillary presentation
of the text illustrations. The Instructor’s Guide contains notes on each chapter’s
organization and content (useful for modifying the book to your specific teaching
needs), topics for class discussion, answers to the chapter review questions from the
textbook, and detailed answers to the For Further Thought questions. The multiple-
choice test bank contains more than 2600 questions that have been organized in
relation to the chapter review questions, and further explanation may be found in the
Instructor’s Guide. The fill-in test bank contains more than 2100 questions organized
by textbook chapter. The Image Ancillary presentation contains many of the illustra-
tions from the textbook, with suggested points for use in classroom lectures.

Suggestions and comments from colleagues are always valuable, and yours would
be greatly appreciated. When we took on the task of writing and illustrating this text-
book, we wanted to make it the most useful book possible for you and your students.
Any suggestions that you can provide to help us achieve that goal are most welcome,
and they may be sent to us in care of F. A. Davis Company, 1915 Arch Street,
Philadelphia, PA 19103.

Valerie C. Scanlon
Dobbs Ferry, New York

Tina Sanders
Castle Creek, New York

Copyright © 2007 by F. A. Davis.

To the Student

This is your textbook for your first course in human anatomy and physiology, a sub-

ject that is both fascinating and rewarding. That you are taking such a course says
something about you. You may simply be curious as to how the human body functions
or you may have a personal goal of making a contribution in one of the healthcare
professions. Whatever your reason, this textbook will help you to be successful in your
anatomy and physiology course.

The material is presented simply and concisely, yet with accuracy and precision.
The writing style is informal yet clear and specific; it is intended to promote your
comprehension and understanding.

ORGANIZATION OF THE TEXTBOOK

To use this textbook effectively, you should know the purpose of its various parts. Each
chapter is organized in the following way:

Chapter Outline—This presents the main topics in the chapter, which corre-
spond to the major headings in the text.

Student Objectives—These summarize what you should know after reading
and studying the chapter. These are not questions to be answered, but are
rather, with the chapter outline, a preview of the chapter contents.

New Terminology and Related Clinical Terminology—These are some of
the new terms you will come across in the chapter. Read through these terms
before you read the chapter, but do not attempt to memorize them just yet.
When you have finished the chapter, return to the list and see how many
terms you can define. Note those you may not be sure of and look them up.
All of these terms are fully defined in the glossary.

Study Outline—This is found at the end of the chapter. It is a concise summary
of the essentials in the chapter. You may find this outline very useful as a quick
review before an exam.

Review Questions—These are also at the end of the chapter. Your instructor
may assign some or all of them as homework. If not, the questions may be
used as a self-test to evaluate your comprehension of the chapter’s content.
The page number(s) in parentheses following each question refers you to the
page(s) in the chapter on which the content needed to answer the question
correctly can be found.

For Further Thought—The heading tells you what these are for: thinking.
Your instructor may use these for class discussion, and, if so, please do not
ever be afraid to be wrong. Being wrong in the classroom is one of the ways
each and every one of us learns. Contribute, raise your hand and speak up
with your best thoughts, and listen to those of others. Together you will find
the answers.

viii

Copyright © 2007 by F. A. Davis.

To the Student ix

OTHER FEATURES WITHIN EACH CHAPTER

Illustrations—These are an essential part of this textbook. Use them. Study
them carefully, and they will be of great help to you as you learn. They are
intended to help you develop your own mental picture of the body and its
parts and processes. You may not have thought of mental pictures as being
important, but they are, and each new one you create is a major step in learn-
ing. Each illustration is referenced in the text, so you will know when to con-
sult it. With a little concentration, you will have it in your mind for whenever
you need it. You will see that each illustration also has a question after the leg-
end. These questions provide an ongoing quiz; try to answer each one as you
come to it. (Will it matter if you’re wrong? No, but answering the questions
will help you to learn.) The answers are given in Appendix G, just before the
glossary.

Boxes—Discussions of clinical applications are in separate boxes in the text so
that you may find and refer to them easily. Your instructor may include all or
some of these as required reading. If you are planning a career in the health
professions, these boxes are an introduction to pathophysiology, and you will
find them interesting and helpful.

Bold Type—This is used whenever a new term is introduced, or when an old
term is especially important. The terms in bold type are fully defined in the
glossary, which includes phonetic pronunciations.

Tables—This format is used to present material in a very concise form. Some
tables are summaries of text material and are very useful for a quick review.
Other tables present additional material that complements the text material.

Glossary—Not within the chapters but at the end, the glossary is the diction-
ary of the book. All of the terms in bold type, as well as others, are defined
here. Make use of it, rather than wonder what a word means. The sooner you
have a definition firmly in your mind, the sooner it is truly part of your
knowledge.

To make the best use of your study time, a Student Workbook is available that will
help you to focus your attention on the essentials in each chapter. Also included are
comprehensive chapter tests to help you determine which topics you have learned
thoroughly and which you may have to review. If your instructor has not made the
workbook a required text, you may wish to ask that it be ordered and made available
in your bookstore. You will find it very helpful.

SOME FINAL WORDS OF ENCOURAGEMENT

Your success in this course depends to a great extent on you. Try to set aside study
time for yourself every day; a little time each day is usually much more productive
than trying to cram at the last minute.

Ask questions of yourself as you are studying. What kinds of questions? The sim-
plest ones. If you are studying a part of the body such as an organ, ask yourself: What
is its name? Where is it? What is it made of? What does it do? That is: name, loca-
tion, structure, and function. These are the essentials. If you are studying a process,
ask yourself: What is happening here? What is its purpose? That is: What is going on?
And what good is it? Again, these are the essentials.

Copyright © 2007 by F. A. Davis.

x To the Student

We hope this textbook will contribute to your success. If you have any suggestions
or comments, we would very much like to hear them. After all, this book was written
for you, to help you achieve your goals in this course and in your education. Please
send your suggestions and comments to us in care of F. A. Davis Company, 1915 Arch
Street, Philadelphia, PA 19103.

Valerie C. Scanlon Tina Sanders
Dobbs Ferry, New York Castle Creek, New York

Copyright © 2007 by F. A. Davis.

Acknowledgments

Writing and illustrating are part of a book, yet never the whole, and we thank the

editors and production staff of the F. A. Davis Company, especially:
• Lisa Deitch, Nursing Editor
• Alan Sorkowitz, of Alan Sorkowitz Editorial Services, Developmental Editor
• Bob Butler, Production Editor
• Michael Bailey, Director of Production
• Patti Cleary, Editor in Chief, Nursing
• Ilysa Richman, Project Editor, Nursing
• Lisa Thompson, Project Editor, Production
• Lorretta Palagi, Copy Editor
• Carolyn O’Brien, for designing the layout and the cover
• Neil Kelly, director of sales, and all of the F. A. Davis sales representatives
VCS
TS

To my students, past and present
VCS

To Brooks, for his encouragement
TS

xi

Copyright © 2007 by F. A. Davis.

Contents

CHAPTER 1 Organization and General Plan of the Body . . . . . . . . .1

Levels of Organization, 4
Metabolism and Homeostasis, 7
Terminology and General Plan of the Body, 12

CHAPTER 2 Some Basic Chemistry . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .21

Elements, 24
Atoms, 24
Chemical Bonds, 25
Chemical Reactions, 28
Inorganic Compounds of Importance, 28
Organic Compounds of Importance, 33

CHAPTER 3 Cells . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .46

Cell Structure, 48
Cellular Transport Mechanisms, 52
The Genetic Code and Protein Synthesis, 56
Cell Division, 60
Aging and Cells, 63

CHAPTER 4 Tissues and Membranes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .67

Epithelial Tissue, 70
Connective Tissue, 74
Muscle Tissue, 79
Nerve Tissue, 81
Membranes, 82
Aging and Tissues, 84

CHAPTER 5 The Integumentary System . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .88

The Skin, 90
Subcutaneous Tissue, 99
Aging and the Integumentary System, 101

CHAPTER 6 The Skeletal System . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .104

xii Functions of the Skeleton, 106
Types of Bone Tissue, 106
Classification of Bones, 106
Embryonic Growth of Bone, 108
Factors That Affect Bone Growth and Maintenance, 108
The Skeleton, 112

Copyright © 2007 by F. A. Davis.

Contents xiii

Joints—Articulations, 128
Aging and the Skeletal System, 128

CHAPTER 7 The Muscular System . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .135

Muscle Structure, 138
Muscle Tone, 140
Muscle Sense, 141
Energy Sources for Muscle Contraction, 141
Muscle Fiber—Microscopic Structure, 142
Contraction—The Sliding Filament Mechanism, 146
Responses to Exercise—Maintaining Homeostasis, 147
Aging and the Muscular System, 149
Major Muscles of the Body, 149

CHAPTER 8 The Nervous System . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .163

Nervous System Divisions, 166
Nerve Tissue, 166
Types of Neurons, 170
Nerves and Nerve Tracts, 171
The Nerve Impulse, 171
The Spinal Cord, 171
The Brain, 176
Meninges and Cerebrospinal Fluid, 184
Cranial Nerves, 186
The Autonomic Nervous System, 187
Aging and the Nervous System, 191

CHAPTER 9 The Senses . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .196

Sensory Pathway, 198
Characteristics of Sensations, 198
Cutaneous Senses, 199
Muscle Sense, 200
Sense of Taste, 200
Sense of Smell, 202
Hunger and Thirst, 202
The Eye, 202
The Ear, 210
Arterial Receptors, 216
Aging and the Senses, 216

CHAPTER 10 The Endocrine System . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .221

Chemistry of Hormones, 225
Regulation of Hormone Secretion, 225
The Pituitary Gland, 225
Thyroid Gland, 231
Parathyroid Glands, 233
Pancreas, 233
Adrenal Glands, 236
Ovaries, 242

Copyright © 2007 by F. A. Davis.

xiv Contents

Testes, 243
Other Hormones, 243
Mechanisms of Hormone Action, 244
Aging and the Endocrine System, 245

CHAPTER 11 Blood . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .250

Characteristics of Blood, 252
Plasma, 252
Blood Cells, 254

CHAPTER 12 The Heart . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .272

Location and Pericardial Membranes, 274
Chambers—Vessels and Valves, 274
Coronary Vessels, 277
Cardiac Cycle and Heart Sounds, 278
Cardiac Conduction Pathway, 279
Heart Rate, 283
Cardiac Output, 283
Regulation of Heart Rate, 284
Aging and the Heart, 286

CHAPTER 13 The Vascular System . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .290

Arteries, 292
Veins, 292
Capillaries, 293
Pathways of Circulation, 296
Velocity of Blood Flow, 306
Blood Pressure, 307
Regulation of Blood Pressure, 310
Aging and the Vascular System, 314

CHAPTER 14 The Lymphatic System and Immunity . . . . . . . . . . . . . . .319

Lymph, 322
Lymph Vessels, 322
Lymphatic Tissue, 322
Immunity, 327
Aging and the Lymphatic System, 337

CHAPTER 15 The Respiratory System . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .342

Divisions of the Respiratory System, 344
Mechanism of Breathing, 347
Pulmonary Volumes, 351
Exchange of Gases, 354
Transport of Gases in the Blood, 355
Regulation of Respiration, 358
Respiration and Acid–Base Balance, 360
Aging and the Respiratory System, 361

Copyright © 2007 by F. A. Davis.

Contents xv

CHAPTER 16 The Digestive System . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .367

Divisions of the Digestive System, 370
Types of Digestion, 370
Oral Cavity, 370
Pharynx, 373
Esophagus, 373
Structural Layers of the Alimentary Tube, 373
Stomach, 376
Small Intestine, 378
Liver, 379
Gallbladder, 379
Pancreas, 379
Completion of Digestion and Absorption, 381
Large Intestine, 385
Other Functions of the Liver, 386
Aging and the Digestive System, 389

CHAPTER 17 Body Temperature and Metabolism . . . . . . . . . . . . . . . . .394

Body Temperature, 396
Metabolism, 400
Aging and Metabolism, 413

CHAPTER 18 The Urinary System . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .417

Kidneys, 421
Formation of Urine, 424
The Kidneys and Acid–Base Balance, 428
Other Functions of the Kidneys, 429
Elimination of Urine, 431
Characteristics of Urine, 432
Aging and the Urinary System, 433

CHAPTER 19 Fluid–Electrolyte and Acid–Base Balance . . . . . . . . . . .439

Water Compartments, 442
Water Intake and Output, 443
Electrolytes, 445
Acid–Base Balance, 446
Aging and Fluid and pH Regulation, 450

CHAPTER 20 The Reproductive Systems . . . . . . . . . . . . . . . . . . . . . . . . . . . . .454

Meiosis, 456
Male Reproductive System, 457
Female Reproductive System, 462
Aging and the Reproductive Systems, 470

CHAPTER 21 Human Development and Genetics . . . . . . . . . . . . . . . . . .474

Human Development, 476
Genetics, 486

Copyright © 2007 by F. A. Davis.

xvi Contents

CHAPTER 22 An Introduction to Microbiology
and Human Disease . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .496

Classification of Microorganisms, 498
Normal Flora, 500
Infectious Disease, 500
Epidemiology, 503
Methods of Control of Microbes, 504
The Pathogens, 507

Appendixes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .528
A Units of Measure, 528
B Abbreviations, 530
C Normal Values for Some Commonly Used Blood Tests, 532
D Normal Values for Some Commonly Used Urine Tests, 533
E Eponymous Terms, 534
F Prefixes, Combining Word Roots, and
Suffixes Used in Medical Terminology, 535
G Answers to the Illustration Questions, 539

Glossary . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .547

Index . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .589

Copyright © 2007 by F. A. Davis.

CHAPTER 1

Organization and General
Plan of the Body

1

Copyright © 2007 by F. A. Davis.

CHAPTER 1

Chapter Outline Student Objectives

Levels of Organization • Define the terms anatomy, physiology, and patho-
Chemicals
Cells physiology. Use an example to explain how they are
Tissues related.
Organs
Organ Systems • Name the levels of organization of the body from
Metabolism and Homeostasis
Terminology and General Plan of the Body simplest to most complex, and explain each.
Body Parts and Areas
Terms of Location and Position • Define the terms metabolism, metabolic rate, and
Body Cavities and Their Membranes
homeostasis, and use examples to explain.
Dorsal cavity
Ventral cavity • Explain how a negative feedback mechanism
Planes and Sections
Areas of the Abdomen works, and how a positive feedback mechanism
differs.
BOX 1–1 REPLACING TISSUES AND ORGANS
BOX 1–2 VISUALIZING THE INTERIOR OF THE BODY • Describe the anatomic position.
• State the anatomic terms for the parts of the body.
• Use proper terminology to describe the location

of body parts with respect to one another.

• Name the body cavities, their membranes, and

some organs within each cavity.

• Describe the possible sections through the body or

an organ.

• Explain how and why the abdomen is divided into

smaller areas. Be able to name organs in these
areas.

2

Copyright © 2007 by F. A. Davis.

Organization and General
Plan of the Body

New Terminology Related Clinical Terminology

Anatomy (uh-NAT-uh-mee) Computed tomography (CT) scan
Body cavity (BAH-dee KAV-i-tee) (kom-PEW-ted toh-MAH-grah-fee SKAN)
Cell (SELL)
Homeostasis (HOH-me-oh-STAY-sis) Diagnosis (DYE-ag-NO-sis)
Inorganic chemicals (IN-or-GAN-ik KEM-i-kuls) Disease (di-ZEEZ)
Meninges (me-NIN-jeez) Magnetic resonance imaging (MRI)
Metabolism (muh-TAB-uh-lizm)
Negative feedback (NEG-ah-tiv FEED-bak) (mag-NET-ik REZ-ah-nanse IM-ah-jing)
Organ (OR-gan) Positron emission tomography (PET)
Organ system (OR-gan SIS-tem)
Organic chemicals (or-GAN-ik KEM-i-kuls) (PAHZ-i-tron e-MISH-un toh-MAH-grah-fee)
Pathophysiology (PATH-oh-FIZZ-ee-AH-luh-jee)
Pericardial membranes (PER-ee-KAR-dee-uhl

MEM-brayns)
Peritoneum/Mesentery (PER-i-toh-NEE-um/MEZ-

en-TER-ee)
Physiology (FIZZ-ee-AH-luh-jee)
Plane (PLAYN)
Pleural membranes (PLOOR-uhl MEM-brayns)
Positive feedback (PAHS-ah-tiv FEED-bak)
Section (SEK-shun)
Tissue (TISH-yoo)

Terms that appear in bold type in the chapter text are defined in the glossary, which begins on page 547.

3

Copyright © 2007 by F. A. Davis.

4 Organization and General Plan of the Body

The human body is a precisely structured container that your knowledge of anatomy and physiology will
become the basis for your further study in the health
of chemical reactions. Have you ever thought of your- professions.
self in this way? Probably not, and yet, in the strictly
physical sense, that is what each of us is. The body LEVELS OF ORGANIZATION
consists of trillions of atoms in specific arrangements
and thousands of chemical reactions proceeding in The human body is organized into structural and
a very orderly manner. That literally describes functional levels of increasing complexity. Each higher
us, and yet it is clearly not the whole story. The keys level incorporates the structures and functions of the
to understanding human consciousness and self- previous level, as you will see. We will begin with the
awareness are still beyond our grasp. We do not yet simplest level, which is the chemical level, and pro-
know what enables us to study ourselves—no other ceed to cells, tissues, organs, and organ systems. All of
animals do, as far as we know—but we have accumu- the levels of organization are depicted in Fig. 1–1.
lated a great deal of knowledge about what we are
made of and how it all works. Some of this knowledge CHEMICALS
makes up the course you are about to take, a course in
basic human anatomy and physiology. The chemicals that make up the body may be divided
into two major categories: inorganic and organic.
Anatomy is the study of body structure, which Inorganic chemicals are usually simple molecules
includes size, shape, composition, and perhaps even made of one or two elements other than carbon (with
coloration. Physiology is the study of how the body a few exceptions). Examples of inorganic chemicals are
functions. The physiology of red blood cells, for exam- water (H2O); oxygen (O2); one of the exceptions, car-
ple, includes what these cells do, how they do it, and bon dioxide (CO2); and minerals such as iron (Fe), cal-
how this is related to the functioning of the rest of the cium (Ca), and sodium (Na). Organic chemicals are
body. Physiology is directly related to anatomy. For often very complex and always contain the elements
example, red blood cells contain the mineral iron in carbon and hydrogen. In this category of organic
molecules of the protein called hemoglobin; this is an chemicals are carbohydrates, fats, proteins, and
aspect of their anatomy. The presence of iron enables nucleic acids. The chemical organization of the body
red blood cells to carry oxygen, which is their function. is the subject of Chapter 2.
All cells in the body must receive oxygen in order to
function properly, so the physiology of red blood cells CELLS
is essential to the physiology of the body as a whole.
The smallest living units of structure and function are
Pathophysiology is the study of disorders of func- cells. There are many different types of human cells,
tioning, and a knowledge of normal physiology makes though they all have certain similarities. Each type of
such disorders easier to understand. For example, you cell is made of chemicals and carries out specific
are probably familiar with the anemia called iron- chemical reactions. Cell structure and function are
deficiency anemia. With insufficient iron in the diet, discussed in Chapter 3.
there will not be enough iron in the hemoglobin of
red blood cells, and hence less oxygen will be trans- TISSUES
ported throughout the body, resulting in the symp-
toms of the iron-deficiency disorder. This example A tissue is a group of cells with similar structure and
shows the relationship between anatomy, physiology, function. There are four groups of tissues:
and pathophysiology.
Epithelial tissues—cover or line body surfaces; some
The purpose of this text is to enable you to gain are capable of producing secretions with specific
an understanding of anatomy and physiology with functions. The outer layer of the skin and sweat
the emphasis on normal structure and function. Many glands are examples of epithelial tissues. Internal
examples of pathophysiology have been included, epithelial tissues include the walls of capillaries
however, to illustrate the relationship of disease to (squamous epithelium) and the kidney tubules
normal physiology and to describe some of the proce- (cuboidal epithelium), as shown in Fig. 1–1.
dures used in the diagnosis of disease. Many of the
examples are clinical applications that will help you
begin to apply what you have learned and demonstrate

Copyright © 2007 by F. A. Davis.
1. Chemical Level

2. Cellular Level Cuboidal epithelium

Squamous epithelium

Smooth muscle
3. Tissue Level

6. Organism Level Kidney

Urinary
bladder

4. Organ Level

Urinary
system

5. Organ System
Level

Figure 1–1. Levels of structural organization of the human body, depicted from the
simplest (chemical) to the most complex (organism). The organ system shown here is the
urinary system.
QUESTION: What other organ system seems to work directly with the urinary system?

5

Copyright © 2007 by F. A. Davis.

6 Organization and General Plan of the Body

Connective tissues—connect and support parts of and stomach. The kidneys contain several kinds of
the body; some transport or store materials. Blood, epithelial, or surface tissues, for their work of absorp-
bone, cartilage, and adipose tissue are examples of tion. The stomach is lined with epithelial tissue that
this group. secretes gastric juice for digestion. Smooth muscle
tissue in the wall of the stomach contracts to mix
Muscle tissues—specialized for contraction, which food with gastric juice and propel it to the small intes-
brings about movement. Our skeletal muscles and tine. Nerve tissue carries impulses that increase or
the heart are examples of muscle tissue. In Fig. 1–1, decrease the contractions of the stomach (see Box 1–1:
you see smooth muscle tissue, which is found in Replacing Tissues and Organs).
organs such as the urinary bladder and stomach.
ORGAN SYSTEMS
Nerve tissue—specialized to generate and transmit
electrochemical impulses that regulate body func- An organ system is a group of organs that all con-
tions. The brain and optic nerves are examples of tribute to a particular function. Examples are the uri-
nerve tissue. nary system, digestive system, and respiratory system.
In Fig. 1–1 you see the urinary system, which consists
The types of tissues in these four groups, as well as of the kidneys, ureters, urinary bladder, and urethra.
their specific functions, are the subject of Chapter 4. These organs all contribute to the formation and
elimination of urine.
ORGANS
As a starting point, Table 1–1 lists the organ sys-
An organ is a group of tissues precisely arranged so as tems of the human body with their general functions,
to accomplish specific functions. Examples of organs and some representative organs, and Fig. 1–2 depicts
are the kidneys, individual bones, the liver, lungs,

BOX 1–1 REPLACING TISSUES AND ORGANS

Blood transfusions are probably the most familiar eventually be used to cover a large surface. Other
and frequent form of “replacement parts” for peo- cells grown in culture include cartilage, bone, pan-
ple. Blood is a tissue, and when properly typed and creas, and liver. Much research is being done on
cross-matched (blood types will be discussed in liver implants (not transplants), clusters of func-
Chapter 11) may safely be given to someone with tional liver cells grown in a lab. Such implants
the same or a compatible blood type. would reduce or eliminate the need for human
donors. Tissue engineering is also being used to cre-
Organs, however, are much more complex struc- ate arteries and urinary bladders.
tures. When a patient receives an organ transplant,
there is always the possibility of rejection (destruc- Many artificial replacement parts have also been
tion) of the organ by the recipient’s immune sys- developed. These are made of plastic or metal and
tem (Chapter 14). With the discovery and use of are not rejected as foreign by the recipient’s
more effective immune-suppressing medications, immune system. Damaged heart valves, for exam-
however, the success rate for many types of organ ple, may be replaced by artificial ones, and sections
transplants has increased. Organs that may be trans- of arteries may be replaced by tubular grafts made
planted include corneas, kidneys, the heart, the of synthetic materials. Artificial joints are available
liver, and the lungs. for every joint in the body, as is artificial bone for
reconstructive surgery. Cochlear implants are tiny
The skin is also an organ, but skin transplanted instruments that convert sound waves to electrical
from another person will not survive very long. impulses the brain can learn to interpret, and have
Several kinds of artificial skin are now available to provided some sense of hearing for people with cer-
temporarily cover large areas of damaged skin. tain types of deafness. Work is also progressing on
Patients with severe burns, for example, will even- the use of a featherweight computer chip as an arti-
tually need skin grafts from their own unburned ficial retina, on devices that help damaged hearts
skin to form permanent new skin over the burn pump blood more efficiently, and on small, self-
sites. It is possible to “grow” a patient’s skin in lab- contained artificial hearts.
oratory culture, so that a small patch of skin may

Copyright © 2007 by F. A. Davis.

Organization and General Plan of the Body 7

Table 1–1 THE ORGAN SYSTEMS

System Functions Organs*
Integumentary skin, subcutaneous tissue
Skeletal • Is a barrier to pathogens and chemicals
• Prevents excessive water loss bones, ligaments
Muscular
Nervous • Supports the body muscles, tendons
• Protects internal organs and red bone marrow
Endocrine • Provides a framework to be moved by muscles brain, nerves, eyes, ears

Circulatory • Moves the skeleton thyroid gland, pituitary
Lymphatic • Produces heat gland, pancreas

Respiratory • Interprets sensory information heart, blood, arteries
Digestive • Regulates body functions such as movement by means
Urinary spleen, lymph nodes
Reproductive of electrochemical impulses
lungs, trachea, larynx,
• Regulates body functions such as growth and reproduc- diaphragm
tion by means of hormones
stomach, colon, liver,
• Regulates day-to-day metabolism by means of hormones pancreas

• Transports oxygen and nutrients to tissues and removes kidneys, urinary bladder,
waste products urethra

• Returns tissue fluid to the blood Female: ovaries, uterus
• Destroys pathogens that enter the body and provides Male: testes, prostate gland

immunity

• Exchanges oxygen and carbon dioxide between the air
and blood

• Changes food to simple chemicals that can be absorbed
and used by the body

• Removes waste products from the blood
• Regulates volume and pH of blood and tissue fluid

• Produces eggs or sperm
• In women, provides a site for the developing

embryo-fetus

*These are simply representative organs, not an all-inclusive list.

all of the organ systems. Some organs are part of two of life. The pumping of the heart, the digestion of
organ systems; the pancreas, for example, is both a food in the stomach, the diffusion of gases in the lungs
digestive and an endocrine organ, and the diaphragm and tissues, and the production of energy in each cell
is part of both the muscular and respiratory systems. of the body are just a few of the thousands of aspects
All of the organ systems make up an individual person. of metabolism. Metabolism comes from a Greek word
The balance of this text discusses each system in more meaning “change,” and the body is always changing in
detail. visible ways (walking down the street), microscopic
ways (cells dividing in the skin to produce new epider-
METABOLISM AND HOMEOSTASIS mis), and submicroscopic or molecular ways (RNA
and enzymes constructing new proteins). A related
Metabolism is a collective noun; it is all of the chem- concept, metabolic rate, is most often used to mean
ical reactions and physical processes that take place the speed at which the body produces energy and heat,
within the body. Metabolism includes growing, repair- or, put another way, energy production per unit of
ing, reacting, and reproducing—all the characteristics time, such as 24 hours. Metabolic rate, therefore, is
one aspect of metabolism.

Copyright © 2007 by F. A. Davis.

Muscular Nervous
system system

Skeletal
system

Integumentary
system

Circulatory system

Figure 1–2. Organ systems. Compare the depiction of each system to its description in
Table 1–1.
QUESTION: Name at least one organ shown in each system.

8

Copyright © 2007 by F. A. Davis.

Respiratory Urinary system Endocrine system
system

Digestive
system

Lymphatic system Reproductive system
Figure 1–2. (Continued)

9

Copyright © 2007 by F. A. Davis.

10 Organization and General Plan of the Body

A person who is in good health may be said to be in heat production is detected by the brain and pituitary
a state of homeostasis. Homeostasis reflects the abil- gland. They then decrease secretion of their hor-
ity of the body to maintain a relatively stable metabo- mones, which in turn inhibits any further secretion of
lism and to function normally despite many constant thyroxine until the metabolic rate decreases again.
changes. The changes that are part of normal metab- Metabolic rate does rise and fall, but is kept within
olism may be internal or external, and the body must normal limits.
respond appropriately.
You may be wondering if there is such a thing as a
Eating breakfast, for example, brings about an positive feedback mechanism. There is, but they are
internal change. Suddenly there is food in the stom- rare in the body and quite different from a negative
ach, and something must be done with it. What hap- feedback mechanism. In a positive feedback mecha-
pens? The food is digested or broken down into nism, the response to the stimulus does not stop or
simple chemicals that the body can use. The protein in reverse the stimulus, but instead keeps the sequence of
a hard-boiled egg is digested into amino acids, its basic events going. A good example is childbirth, in which
chemical building blocks; these amino acids can then the sequence of events, simply stated, is as follows:
be used by the cells of the body to produce their own Stretching of the uterine cervix stimulates secretion of
specialized proteins. the hormone oxytocin by the posterior pituitary gland.
Oxytocin stimulates contraction of the uterine muscle,
An example of an external change is a rise in envi- which causes more stretching, which stimulates more
ronmental temperature. On a hot day, the body tem- oxytocin and, hence, more contractions. The mecha-
perature would also tend to rise. However, body nism stops with the delivery of the baby and the pla-
temperature must be kept within its normal range of centa. This is the “brake,” the interrupting event.
about 97Њ to 99ЊF (36Њ to 38ЊC) in order to support
normal functioning. What happens? One of the body’s Any positive feedback mechanism requires an
responses to the external temperature rise is to external “brake,” something to interrupt it. Blood
increase sweating so that excess body heat can be lost clotting is such a mechanism, and without external
by the evaporation of sweat on the surface of the skin. controls, clotting may become a vicious cycle of clot-
This response, however, may bring about an undesir- ting and more clotting, doing far more harm than
able internal change, dehydration. What happens? As good (discussed in Chapter 11). Inflammation follow-
body water decreases, we feel the sensation of thirst ing an injury is beneficial and necessary for repair to
and drink fluids to replace the water lost in sweating. begin, but the process may evolve into a cycle of dam-
Notice that when certain body responses occur, they age and more damage. The rise of a fever may also
reverse the event that triggered them. In the preced- trigger a positive feedback mechanism. Notice in Fig.
ing example a rising body temperature stimulates 1–3 that bacteria have affected the body’s thermostat
increased sweating, which lowers body temperature, in the hypothalamus and caused a fever. The rising
which in turn decreases sweating. Unnecessary sweat- body temperature increases the metabolic rate, which
ing that would be wasteful of water is prevented. This increases body temperature even more, becoming a
is an example of a negative feedback mechanism, in cycle. Where is the inhibition, the brake? For this
which the body’s response reverses the stimulus (in infection, the brake is white blood cells destroying the
effect, turning it off for a while) and keeps some aspect bacteria that caused the fever. An interruption from
of the body metabolism within its normal range. outside the cycle is necessary. It is for this reason,
because positive feedback mechanisms have the poten-
Look at Fig. 1–3 for another negative feedback tial to be self-perpetuating and cause harm, that they
mechanism, one in which the hormone thyroxine reg- are rare in the body.
ulates the metabolic rate of the body. As metabolic
rate decreases, the hypothalamus (part of the brain) Negative feedback mechanisms, however, contain
and pituitary gland detect this decrease and secrete their own brakes in that inhibition is a natural part of
hormones to stimulate the thyroid gland (on the front the cycle, and the body has many of them. The secre-
of the neck just below the larynx) to secrete the hor- tion of most hormones (Chapter 10) is regulated by
mone thyroxine. Thyroxine stimulates the cellular negative feedback mechanisms. The regulation of
enzyme systems that produce energy from food, which heart rate (Chapter 12) and blood pressure (Chapter
increases the metabolic rate. The rise in energy and 13) involves several negative feedback mechanisms.

Copyright © 2007 by F. A. Davis.

Organization and General Plan of the Body 11

A Hypothalamus
and pituitary gland
Thyroid gland
Thyroxine No longer Metabolic
Cells decrease decreases stimulates rate
energy thyroid gland
increases
production

Hypothalamus Thyroid gland
and pituitary gland
Cells increase
Metabolic Stimulates Thyroxine energy
rate thyroid increases
gland production
decreases

B

Hypothalamus

Cells increase Fever Metabolic
heat rate

production increases

Bacteria Heat gain
mechanisms

White blood cells Key:
Stimulates
Inhibits Leads to

Figure 1–3. Feedback mechanisms. (A) The negative feedback mechanism of regulation
of metabolic rate by thyroxine. (B) The positive feedback mechanism triggered by a fever.
See text for description.
QUESTION: For each mechanism, where is the source of the “brake” or inhibition?

The result of all of these mechanisms working to- of the human body, keep in mind that the proper func-
gether is that all aspects of body functioning, that is, of tioning of each organ and organ system contributes to
metabolism, are kept within normal limits, a steady homeostasis. Keep in mind as well that what we call
state or equilibrium. This is homeostasis. the normal values of metabolism are often ranges, not
single numbers. Recall that normal body temperature
In the chapters to come, you will find many more is a range: 97Њ to 99ЊF (36Њ to 38ЊC). Normal pulse
examples of homeostasis. As you continue your study

Copyright © 2007 by F. A. Davis.

12 Organization and General Plan of the Body

rate, another example, is 60 to 80 beats per minute; a Table 1–2 DESCRIPTIVE TERMS FOR
normal respiratory rate is 12 to 20 breaths per minute. BODY PARTS AND AREAS
Variations within the normal range are part of normal
metabolism. Term Definition (Refers to)

TERMINOLOGY AND GENERAL Antebrachial forearm
PLAN OF THE BODY Antecubital front of elbow
Axillary armpit
As part of your course in anatomy and physiology, Brachial upper arm
you will learn many new words or terms. At times you Buccal (oral) mouth
may feel that you are learning a second language, and Cardiac heart
indeed you are. Each term has a precise meaning, Cervical neck
which is understood by everyone else who has learned Cranial head
the language. Mastering the terminology of your pro- Cutaneous skin
fession is essential to enable you to communicate effec- Deltoid shoulder
tively with your coworkers and your future patients. Femoral thigh
Although the number of new terms may seem a bit Frontal forehead
overwhelming at first, you will find that their use soon Gastric stomach
becomes second nature to you. Gluteal buttocks
Hepatic liver
The terminology presented in this chapter will be Iliac hip
used throughout the text in the discussion of the organ Inguinal groin
systems. This will help to reinforce the meanings of Lumbar small of back
these terms and will transform these new words into Mammary breast
knowledge. Nasal nose
Occipital back of head
BODY PARTS AND AREAS Orbital eye
Parietal crown of head
Each of the terms listed in Table 1–2 and shown in Patellar kneecap
Fig. 1–4 refers to a specific part or area of the body. Pectoral chest
For example, the term femoral always refers to the Pedal foot
thigh. The femoral artery is a blood vessel that passes Perineal pelvic floor
through the thigh, and the quadriceps femoris is a Plantar sole of foot
large muscle group of the thigh. Popliteal back of knee
Pulmonary lungs
Another example is pulmonary, which always refers Renal kidney
to the lungs, as in pulmonary artery, pulmonary edema, Sacral base of spine
and pulmonary embolism. Although you may not Scapular shoulder blade
know the exact meaning of each of these terms now, Sternal breastbone
you do know that each has something to do with the Temporal side of head
lungs. Umbilical navel
Volar (palmar) palm
TERMS OF LOCATION AND POSITION
these are pairs of terms and that each pair is a set of
When describing relative locations, the body is always opposites. This will help you recall the terms and their
assumed to be in anatomic position: standing upright meanings.
facing forward, arms at the sides with palms forward,
and the feet slightly apart. The terms of location are BODY CAVITIES AND
listed in Table 1–3, with a definition and example for THEIR MEMBRANES
each. As you read each term, find the body parts used
as examples in Figs. 1–4 and 1–5. Notice also that The body has two major cavities: the dorsal cavity
(posterior) and the ventral cavity (anterior). Each of
these cavities has further subdivisions, which are
shown in Fig. 1–5.

Copyright © 2007 by F. A. Davis.

Organization and General Plan of the Body 13

Orbital Body Parts and Areas Parietal
Nasal Anatomic position Occipital
Buccal
Cranial Scapular
Sternal
Frontal Lumbar
Axillary Temporal Sacral

Antecubital Cervical
Antebrachial Deltoid
Pectoral
Umbilical Mammary
Brachial

Iliac

Volar Inguinal Gluteal
Femoral Perineal

Popliteal
Patellar

Pedal Plantar
A B

Figure 1–4. Body parts and areas. The body is shown in anatomic position. (A) Anterior
view. (B) Posterior view. (Compare with Table 1–2.)
QUESTION: Name a body area that contains a bone with a similar name. Can you name
two more?

Dorsal Cavity Ventral Cavity

The dorsal cavity contains the central nervous system, The ventral cavity consists of two compartments, the
and consists of the cranial cavity and the vertebral or thoracic cavity and the abdominal cavity, which are
spinal cavity. The dorsal cavity is a continuous one; separated by the diaphragm. The diaphragm is a large,
that is, no wall or boundary separates its subdivisions. dome-shaped respiratory muscle. It has openings for
The cranial cavity is formed by the skull and contains the esophagus and for large blood vessels, but other-
the brain. The spinal cavity is formed by the backbone wise is a wall between the thoracic and abdominal cav-
(spine) and contains the spinal cord. The membranes ities. The pelvic cavity may be considered a
that line these cavities and cover the brain and spinal subdivision of the abdominal cavity (there is no wall
cord are called the meninges. between them) or as a separate cavity.

Copyright © 2007 by F. A. Davis.

Table 1–3 TERMS OF LOCATION AND POSITION

Term Definition Example

Superior above, or higher The heart is superior to the liver.
Inferior below, or lower The liver is inferior to the lungs.
Anterior toward the front The chest is on the anterior side of the body.
Posterior toward the back The lumbar area is posterior to the umbilical area.
Ventral toward the front The mammary area is on the ventral side of the body.
Dorsal toward the back The buttocks are on the dorsal side of the body.
Medial toward the midline The heart is medial to the lungs.
Lateral away from the midline The shoulders are lateral to the neck.
Internal within, or interior to The brain is internal to the skull.
External outside, or exterior to The ribs are external to the lungs.
Superficial toward the surface The skin is the most superficial organ.
Deep within, or interior to The deep veins of the legs are surrounded by muscles.
Central the main part The brain is part of the central nervous system.
Peripheral extending from the main part Nerves in the arm are part of the peripheral nervous system.
Proximal closer to the origin The knee is proximal to the foot.
Distal farther from the origin The palm is distal to the elbow.
Parietal pertaining to the wall of a cavity The parietal pleura lines the chest cavity.
Visceral pertaining to the organs within a cavity The visceral pleura covers the lungs.

Thoracic cavity Cranial cavity
Foramen magnum Dorsal
Diaphragm
cavity
Ventral Abdominal cavity Spinal cavity
cavity
Figure 1–5. Body cavities (lateral view
Pelvic cavity from the left side).
Symphysis pubis QUESTION: Which of these cavities are
surrounded by bone?
14
Sacral promontory

Copyright © 2007 by F. A. Davis.

Organization and General Plan of the Body 15

Organs in the thoracic cavity include the heart and folded around and covering the outer surfaces of the
lungs. The membranes of the thoracic cavity are abdominal organs.
serous membranes called the pleural membranes.
The parietal pleura lines the chest wall, and the vis- The pelvic cavity is inferior to the abdominal cav-
ceral pleura covers the lungs. The heart has its own set ity. Although the peritoneum does not line the pelvic
of serous membranes called the pericardial mem- cavity, it covers the free surfaces of several pelvic
branes. The parietal pericardium lines the fibrous organs. Within the pelvic cavity are the urinary blad-
pericardial sac, and the visceral pericardium covers the der and reproductive organs such as the uterus in
heart muscle. women and the prostate gland in men.

Organs in the abdominal cavity include the liver, PLANES AND SECTIONS
stomach, and intestines. The membranes of the
abdominal cavity are also serous membranes called the When internal anatomy is described, the body or an
peritoneum and mesentery. The peritoneum is the organ is often cut or sectioned in a specific way so as
membrane that lines the entire abdominal wall, and to make particular structures easily visible. A plane is
the mesentery is the continuation of this membrane, an imaginary flat surface that separates two portions of

-

B

A

Figure 1–6. (A) Planes and sections of the body. (B) Cross-section and longitudinal sec-
tion of the small intestine.
QUESTION: What other organs would have sections that look like those of the small intes-
tine?

Copyright © 2007 by F. A. Davis.

16 Organization and General Plan of the Body

Stomach Front
Pancreas
Liver
Gallbladder

Colon Duodenum
Spleen Ribs
Inferior vena cava
Aorta
Left kidney

Vertebra

Spinal cord Right kidney

Back Muscle
C

Figure 1–6. (Continued) (C) Transverse section through the upper abdomen.

the body or an organ. These planes and sections are cian or nurse would want to know more precisely
shown in Fig. 1–6 (see Box 1–2: Visualizing the where the pain was. To determine this, the abdomen
Interior of the Body). may be divided into smaller regions or areas, which
are shown in Fig. 1–7.
Frontal (coronal) section—a plane from side to side
separates the body into front and back portions. Quadrants—a transverse plane and a midsagittal
plane that cross at the umbilicus will divide the
Sagittal section—a plane from front to back separates abdomen into four quadrants. Clinically, this is
the body into right and left portions. A midsagittal probably the division used more frequently. The
section creates equal right and left halves. pain of gallstones might then be described as in the
right upper quadrant.
Transverse section—a horizontal plane separates the
body into upper and lower portions. Nine areas—two transverse planes and two sagittal
planes divide the abdomen into nine areas:
Cross-section—a plane perpendicular to the long Upper areas—above the level of the rib cartilages are
axis of an organ. A cross-section of the small intes- the left hypochondriac, epigastric, and right
tine (which is a tube) would look like a circle with hypochondriac.
the cavity of the intestine in the center. Middle areas—the left lumbar, umbilical, and right
lumbar.
Longitudinal section—a plane along the long axis of Lower areas—below the level of the top of the pelvic
an organ. A longitudinal section of the intestine is bone are the left iliac, hypogastric, and right
shown in Fig. 1–6, and a frontal section of the iliac.
femur (thigh bone) would also be a longitudinal
section (see Fig. 6–1 in Chapter 6). These divisions are often used in anatomic studies
to describe the location of organs. The liver, for exam-
AREAS OF THE ABDOMEN ple, is located in the epigastric and right hypochon-
driac areas.
The abdomen is a large area of the lower trunk of the
body. If a patient reported abdominal pain, the physi-

Copyright © 2007 by F. A. Davis.

Organization and General Plan of the Body 17

AB

Figure 1–7. Areas of the abdomen. (A) Four quadrants. (B) Nine regions.
QUESTION: Are there any organs found in all four abdominal quadrants?

SUMMARY nal changes. In the chapters that follow, you will find
detailed descriptions of the physiology of each organ
As you will see, the terminology presented in this and organ system, and how the metabolism of each is
chapter is used throughout the text to describe the necessary to homeostasis. We will now return to a
anatomy of organs and the names of their parts. All consideration of the structural organization of the
organs of the body contribute to homeostasis, the body and to more extensive descriptions of its levels of
healthy state of the body that is maintained by con- organization. The first of these, the chemical level, is
stant and appropriate responses to internal and exter- the subject of the next chapter.

Copyright © 2007 by F. A. Davis.

18 Organization and General Plan of the Body

BOX 1–2 VISUALIZING THE INTERIOR OF THE BODY

In the past, the need for exploratory surgery possible using any other technique. The patient
brought with it hospitalization, risk of infection, and is placed inside a strong magnetic field, and the
discomfort and pain for the patient. Today, how- tissues are pulsed with radio waves. Because
ever, several technologies and the extensive use of each tissue has different proportions of various
computers permit us to see the interior of the body atoms, which resonate or respond differently,
without surgery. each tissue emits a characteristic signal. A com-
puter then translates these signals into an image;
Computed tomography (CT) scanning uses a the entire procedure takes 30 to 45 minutes.
narrowly focused x-ray beam that circles rapidly Positron emission tomography (PET) scanning
around the body. A detector then measures how creates images that depict the rates of physio-
much radiation passes through different tissues, logical processes such as blood flow, oxygen
and a computer constructs an image of a thin usage, or glucose metabolism. The comparative
slice through the body. Several images may be rates are depicted by colors: Red represents the
made at different levels—each takes only a few highest rate, followed by yellow, then green, and
seconds—to provide a more complete picture of finally blue representing the lowest rate.
an organ or part of the body. The images are
much more detailed than are those produced by One drawback of these technologies is their cost;
conventional x-rays. they are expensive. However, the benefits to
patients are great: Highly detailed images of the
Magnetic resonance imaging (MRI) is another body are obtained without the risks of surgery and
diagnostic tool that is especially useful for visual- with virtually no discomfort in the procedures them-
izing soft tissues, including the brain and spinal selves.
cord. Recent refinements have produced images
of individual nerve bundles, which had not been

ABC

Box Figure 1–A Imaging techniques. (A) CT scan of eye in lateral view showing a tumor (arrow)
below the optic nerve. (B) MRI of midsagittal section of head (compare with Figs. 8–6 and 15–1).
(C) PET scan of brain in transverse section (frontal lobes at top) showing glucose metabolism. (From
Mazziotta, JC, and Gilman, S: Clinical Brain Imaging: Principles and Applications. FA Davis,
Philadelphia, 1992, pp 27 and 298, with permission.)

STUDY OUTLINE Levels of Organization
1. Chemical—inorganic and organic chemicals make
Introduction
1. Anatomy—the study of structure. up all matter, both living and non-living.
2. Physiology—the study of function. 2. Cells—the smallest living units of the body.
3. Pathophysiology—the study of disorders of func-

tioning.

Copyright © 2007 by F. A. Davis.

Organization and General Plan of the Body 19

3. Tissues—groups of cells with similar structure and 2. Terms of location and position—used to describe
function. relationships of position (see Table 1–3 and Figs.
1–4 and 1–5).
4. Organs—groups of tissues that contribute to spe-
cific functions. 3. Body cavities and their membranes (see Fig. 1–5).
• Dorsal cavity—lined with membranes called
5. Organ systems—groups of organs that work meninges; consists of the cranial and vertebral
together to perform specific functions (see Table cavities.
1–1 and Fig. 1–2). • Cranial cavity contains the brain.
• Vertebral cavity contains the spinal cord.
6. Person—all the organ systems functioning prop- • Ventral cavity—the diaphragm separates the tho-
erly. racic and abdominal cavities; the pelvic cavity is
inferior to the abdominal cavity.
Metabolism and Homeostasis • Thoracic cavity—contains the lungs and heart.
1. Metabolism is the sum of all of the chemical and — Pleural membranes line the chest wall and
cover the lungs.
physical changes that take place in the body. — Pericardial membranes surround the
Metabolic rate is the amount of energy and heat heart.
production per unit of time. • Abdominal cavity—contains many organs
2. Homeostasis is a state of good health maintained including the stomach, liver, and intestines.
by the normal metabolism (functioning) of the — The peritoneum lines the abdominal cav-
organ systems. ity; the mesentery covers the abdominal
3. The body constantly responds to internal and organs.
external changes, yet remains stable; its many • Pelvic cavity—contains the urinary bladder
aspects of metabolism are kept within normal lim- and reproductive organs.
its (usually a range of values, not a single value).
4. Negative feedback mechanism—a control system 4. Planes and sections—cutting the body or an organ
in which a stimulus initiates a response that in a specific way (see Fig. 1–6).
reverses or reduces the stimulus, thereby stopping • Frontal or coronal—separates front and back
the response until the stimulus occurs again and parts.
there is a need for the response (see Fig. 1–3). • Sagittal—separates right and left parts.
5. Positive feedback mechanism—a control system • Transverse—separates upper and lower parts.
that requires an external interruption or brake. Has • Cross—a section perpendicular to the long axis.
the potential to become a self-perpetuating and • Longitudinal—a section along the long axis.
harmful cycle, therefore is rare in the body (see Fig.
1–3). 5. Areas of the abdomen—permits easier description
of locations:
Terminology and General Plan of the Body • Quadrants—see Fig. 1–7.
1. Body parts and areas—see Table 1–2 and Fig. 1–4. • Nine areas—see Fig. 1–7.

REVIEW QUESTIONS a. Moves the skeleton

1. Explain how the physiology of a bone is related to b. Regulates body functions by means of hormones
its anatomy. Explain how the physiology of the
hand is related to its anatomy. (p. 4) c. Covers the body and prevents entry of
pathogens
2. Describe anatomic position. Why is this knowl-
edge important? (p. 12) d. Destroys pathogens that enter the body

3. Name the organ system with each of the following e. Exchanges oxygen and carbon dioxide between
functions: (p. 7) the air and blood

Copyright © 2007 by F. A. Davis.

20 Organization and General Plan of the Body

4. Name the two major body cavities and their subdi- 9. Define organ. When a group of organs works
visions. Name the cavity lined by the peritoneum, together, what name is it given? (p. 6)
meninges, and parietal pleura. (pp. 13, 15)
10. Define metabolism, metabolic rate, and ho-
5. Name the four quadrants of the abdomen. Name at meostasis. (pp. 7, 10)
least one organ in each quadrant. (p. 17) a. Give an example of an external change and
explain how the body responds to maintain
6. Name the section through the body that would homeostasis
result in each of the following: equal right and left b. Give an example of an internal change and
halves, anterior and posterior parts, superior and explain how the body responds to maintain
inferior parts. (pp. 15–16) homeostasis
c. Briefly explain how a negative feedback mech-
7. Review Table 1–2, and try to find each external area anism works, and how a positive feedback
on your own body. (pp. 12–13) mechanism differs

8. Define cell. When similar cells work together, what
name are they given? (p. 4)

FOR FURTHER THOUGHT abdominal quadrant? (If you’re not sure, take a
look at Fig. 16–1 in Chapter 16.) Surgery is usually
1. The human foot is similar to the human hand, but necessary to remove an inflamed appendix before it
does have anatomic differences. Describe two of ruptures and causes peritonitis. Using your knowl-
these differences, and explain how they are related edge of the location of the peritoneum, explain why
to the physiology of the hand and the foot. peritonitis is a very serious condition.

2. Complete each statement using the everyday term 5. Keep in mind your answer to Question 4, and
for the body part. explain why bacterial meningitis can be a very seri-
a. The distal femoral area is immediately superior ous infection.
to the ____.
b. The proximal brachial area is immediately infe- 6. Use a mental picture to cut the following sections.
rior to the ____. Then describe in simple words what each section
c. The patellar area is directly proximal to the looks like, and give each a proper anatomic name.
____.
d. The volar area is directly distal to the ____. First: a tree trunk cut top to bottom, then cut side
to side.
3. Name a structure or organ that is both superior and
inferior to the brain. Name one that is both ante- Second: a grapefruit cut top to bottom (straight
rior and posterior. down from where the stem was attached), then
sliced through its equator.
4. If a person has appendicitis (inflammation of the
appendix caused by bacteria), pain is felt in which

Copyright © 2007 by F. A. Davis.

CHAPTER 2

Some Basic Chemistry

21

Copyright © 2007 by F. A. Davis.

Chapter Outline CHAPTER 2

Elements Student Objectives
Atoms • Define the terms element, atom, proton, neutron, and
Chemical Bonds
Ionic Bonds electron.
Covalent Bonds
Disulfide Bonds and Hydrogen Bonds • Describe the formation and purpose of ionic
Chemical Reactions
Inorganic Compounds of Importance bonds, covalent bonds, disulfide bonds, and hydro-
Water gen bonds.
Water Compartments
Oxygen • Describe what happens in synthesis and decompo-
Carbon Dioxide
Cell Respiration sition reactions.
Trace Elements
Acids, Bases, and pH • Explain the importance of water to the function-

Buffer systems ing of the human body.
Organic Compounds of Importance
Carbohydrates • Name and describe the water compartments.
Lipids • Explain the roles of oxygen and carbon dioxide in
Proteins
cell respiration.
Enzymes
Nucleic Acids • State what trace elements are, and name some,

DNA and RNA with their functions.
ATP
• Explain the pH scale. State the normal pH ranges
BOX 2–1
BOX 2–2 of body fluids.
BOX 2–3
BOX 2–4 • Explain how a buffer system limits great changes

in pH.

• Describe the functions of monosaccharides, disac-

charides, oligosaccharides, and polysaccharides.

• Describe the functions of true fats, phospholipids,

and steroids.

• Describe the functions of proteins, and explain

how enzymes function as catalysts.

• Describe the functions of DNA, RNA, and ATP.

BLOOD GASES
NITRIC OXIDE
LIPIDS IN THE BLOOD

A PROTEIN MYSTERY: PRIONS

22

Copyright © 2007 by F. A. Davis.

Some Basic Chemistry

New Terminology Related Clinical Terminology

Acid (ASS-sid) Acidosis (ASS-i-DOH-sis)
Amino acid (ah-MEE-noh ASS-sid) Atherosclerosis (ATH-er-oh-skle-ROH-sis)
Atom (A-tum) Hypoxia (high-POK-see-ah)
Base (BAYSE) Saturated fats (SAT-uhr-ay-ted)
Buffer system (BUFF-er SIS-tem) Unsaturated (un-SAT-uhr-ay-ted) fats
Carbohydrates (KAR-boh-HIGH-drayts)
Catalyst (KAT-ah-list)
Cell respiration (SELL RES-pi-RAY-shun)
Covalent bond (ko-VAY-lent)
Dissociation/ionization (dih-SEW-see-AY-

shun/EYE-uh-nih-ZAY-shun)
Element (EL-uh-ment)
Enzyme (EN-zime)
Extracellular fluid (EKS-trah-SELL-yoo-ler)
Intracellular fluid (IN-trah-SELL-yoo-ler)
Ion (EYE-on)
Ionic bond (eye-ON-ik)
Lipids (LIP-ids)
Matter (MAT-ter)
Molecule (MAHL-e-kuhl)
Nucleic acids (new-KLEE-ik ASS-sids)
pH and pH scale (pee-h SKALE)
Protein (PROH-teen)
Salt (SAWLT)
Solvent/solution (SAHL-vent/suh-LOO-shun)
Steroid (STEER-oyd)
Trace elements (TRAYSE EL-uh-ments)

Terms that appear in bold type in the chapter text are defined in the glossary, which begins on page 547.

23

Copyright © 2007 by F. A. Davis.

24 Some Basic Chemistry

When you hear or see the word chemistry, you may Table 2–1 ELEMENTS IN THE
HUMAN BODY
think of test tubes and Bunsen burners in a laboratory
experiment. However, literally everything in our phys- Elements Symbol Atomic Percent of
ical world is made of chemicals. The paper used for Number* the Body
this book, which was once the wood of a tree, is made Hydrogen H by Weight
of chemicals. The air we breathe is a mixture of chem- Carbon C
icals in the form of gases. Water, gasoline, and diet Nitrogen N 1 9.5
soda are chemicals in liquid form. Our foods are Oxygen O 6 18.5
chemicals, and our bodies are complex arrangements Fluorine F 7 3.3
of thousands of chemicals. Recall from Chapter 1 that Sodium Na 8 65.0
the simplest level of organization of the body is the Magnesium Mg 9 Trace
chemical level. Phosphorus P 11 0.2
Sulfur S 12 0.1
This chapter covers some very basic aspects of Chlorine Cl 15 1.0
chemistry as they are related to living organisms, and Potassium K 16 0.3
most especially as they are related to our understand- Calcium Ca 17 0.2
ing of the human body. So try to think of chemistry Manganese Mn 19 0.4
not as a complicated science, but as the air, water, and Iron Fe 20 1.5
food we need, and every substance that is part of us. Cobalt Co 25 Trace
Copper Cu 26 Trace
ELEMENTS Zinc Zn 27 Trace
Iodine I 29 Trace
All matter, both living and not living, is made of ele- 30 Trace
ments, the simplest chemicals. An element is a sub- 53 Trace
stance made of only one type of atom (therefore, an
atom is the smallest part of an element). There are 92 *Atomic number is the number of protons in the nucleus of
naturally occurring elements in the world around us. the atom. It also represents the number of electrons that
Examples are hydrogen (H), iron (Fe), oxygen (O), orbit the nucleus.
calcium (Ca), nitrogen (N), and carbon (C). In nature,
an element does not usually exist by itself but rather books, articles, hospital lab reports, and so on. Notice
combines with the atoms of other elements to form that if a two-letter symbol is used for an element, the
compounds. Examples of some compounds important second letter is always lowercase, not a capital. For
to our study of the human body are water (H2O), in example, the symbol for calcium is Ca, not CA. CA is
which two atoms of hydrogen combine with one atom an abbreviation often used for cancer.
of oxygen; carbon dioxide (CO2), in which an atom of
carbon combines with two atoms of oxygen; and glu- ATOMS
cose (C6H12O6), in which six carbon atoms and six
oxygen atoms combine with 12 hydrogen atoms. Atoms are the smallest parts of an element that have
the characteristics of that element. An atom consists of
The elements carbon, hydrogen, oxygen, nitrogen, three major subunits or particles: protons, neutrons,
phosphorus, and sulfur are found in all living things. If and electrons (Fig. 2–1). A proton has a positive elec-
calcium is included, these seven elements make up trical charge and is found in the nucleus (or center) of
approximately 99% of the human body (weight). the atom. A neutron is electrically neutral (has no
charge) and is also found in the nucleus. An electron
More than 20 different elements are found, in vary- has a negative electrical charge and is found outside
ing amounts, in the human body. Some of these are the nucleus orbiting in what may be called an electron
listed in Table 2–1. As you can see, each element has a cloud or shell around the nucleus.
standard chemical symbol. This is simply the first (and
sometimes the second) letter of the element’s English The number of protons in an atom gives it its
or Latin name. You should know the symbols of the atomic number. Protons and neutrons have mass and
elements in this table, because they are used in text- weight; they give an atom its atomic weight. In an

Copyright © 2007 by F. A. Davis.

Some Basic Chemistry 25

Second energy level atoms. In this way, the atom becomes stable, because
First energy level its outermost shell of electrons has been filled. It is
these reactive atoms that are of interest in our study of
Proton [+] Nucleus anatomy and physiology.
Neutron
CHEMICAL BONDS
Electrons [--]
A chemical bond is not a structure, but rather a force
Figure 2–1. An atom of carbon. The nucleus contains or attraction between positive and negative electrical
six protons and six neutrons (not all are visible here). Six charges that keeps two or more atoms closely associ-
electrons orbit the nucleus, two in the first energy level ated with each other to form a molecule. By way of
and four in the second energy level. comparison, think of gravity. We know that gravity is
QUESTION: What is the electrical charge of this atom as not a “thing,” but rather the force that keeps our feet
a whole? on the floor and allows us to pour coffee with consis-
tent success. Molecules formed by chemical bonding
atom, the number of protons (ϩ) equals the number of often have physical characteristics different from those
electrons (Ϫ); therefore, an atom is electrically neu- of the atoms of the original elements. For example,
tral. The electrons, however, are important in that the elements hydrogen and oxygen are gases, but
they may enable an atom to connect, or bond, to other atoms of each may chemically bond to form molecules
atoms to form molecules. A molecule is a combina- of water, which is a liquid.
tion of atoms (usually of more than one element) that
are so tightly bound together that the molecule The type of chemical bonding depends upon the
behaves as a single unit. tendencies of the electrons of atoms involved, as you
will see. Four kinds of bonds are very important to the
Each atom is capable of bonding in only very spe- chemistry of the body: ionic bonds, covalent bonds,
cific ways. This capability depends on the number and disulfide bonds, and hydrogen bonds.
the arrangement of the electrons of the atom.
Electrons orbit the nucleus of an atom in shells or IONIC BONDS
energy levels. The first, or innermost, energy level
can contain a maximum of two electrons and is then An ionic bond involves the loss of one or more elec-
considered stable. The second energy level is stable trons by one atom and the gain of the electron(s) by
when it contains its maximum of eight electrons. The another atom or atoms. Refer to Fig. 2–2 as you read
remaining energy levels, more distant from the the following.
nucleus, are also most stable when they contain eight
electrons, or a multiple of eight. An atom of sodium (Na) has one electron in its out-
ermost shell, and in order to become stable, it tends to
A few atoms (elements) are naturally stable, or lose that electron. When it does so, the sodium atom
uninterested in reacting, because their outermost has one more proton than it has electrons. Therefore,
energy level already contains the maximum number of it now has an electrical charge (or valence) of ϩ1 and
electrons. The gases helium and neon are examples of is called a sodium ion (Naϩ). An atom of chlorine has
these stable atoms, which do not usually react with seven electrons in its outermost shell, and in order to
other atoms. Most atoms are not stable, however, and become stable tends to gain one electron. When it
tend to gain, lose, or share electrons in order to fill does so, the chlorine atom has one more electron than
their outermost shell. By doing so, an atom is capable it has protons, and now has a charge (valence) of Ϫ1.
of forming one or more chemical bonds with other It is called a chloride ion (ClϪ).

When an atom of sodium loses an electron to an
atom of chlorine, their ions have unlike charges (pos-
itive and negative) and are thus attracted to one
another. The result is the formation of a molecule of
sodium chloride: NaCl, or common table salt. The
bond that holds these ions together is called an ionic
bond.

Copyright © 2007 by F. A. Davis. Cl = NaCl
+
26 Some Basic Chemistry

Na +

–

Figure 2–2. Formation of an ionic bond. An atom of sodium loses an electron to an
atom of chlorine. The two ions formed have unlike charges, are attracted to one another,
and form a molecule of sodium chloride.
QUESTION: Why is the charge of a sodium ion ϩ1?

Another example is the bonding of chlorine to cal- part in another reaction since it is tightly bound to the
cium. An atom of calcium has two electrons in its out- sodium atom. However, the ClϪ ions available from
ermost shell and tends to lose those electrons in order ionized NaCl in the cellular water can be used for the
to become stable. If two atoms of chlorine each gain synthesis, or chemical manufacture, of HCl in the
one of those electrons, they become chloride ions. stomach.
The positive and negative ions are then attracted to
one another, forming a molecule of calcium chloride, COVALENT BONDS
CaCl2, which is also a salt. A salt is a molecule made
of ions other than hydrogen (Hϩ) ions or hydroxyl Covalent bonds involve the sharing of electrons
(OHϪ) ions. between atoms. As shown in Fig. 2–3, an atom of oxy-
gen needs two electrons to become stable. It may
Ions with positive charges are called cations. These share two of its electrons with another atom of oxy-
include Naϩ, Caϩ2, Kϩ, Feϩ2, and Mgϩ2. Ions with gen, also sharing two electrons. Together they form a
negative charges are called anions, which include ClϪ, molecule of oxygen gas (O2), which is the form in
SO4Ϫ2 (sulfate), and HCO3Ϫ (bicarbonate). The types which oxygen exists in the atmosphere.
of compounds formed by ionic bonding are salts,
acids, and bases. (Acids and bases are discussed later in An atom of oxygen may also share two of its elec-
this chapter.) trons with two atoms of hydrogen, each sharing its
single electron (see Fig. 2–3). Together they form a
In the solid state, ionic bonds are relatively strong. molecule of water (H2O). When writing structural
Our bones, for example, contain the salt calcium car- formulas for chemical molecules, a pair of shared elec-
bonate (CaCO3), which helps give bone its strength. trons is indicated by a single line, as shown in the for-
However, in an aqueous (water) solution, many ionic mula for water; this is a single covalent bond. A double
bonds are weakened. The bonds may become so weak covalent bond is indicated by two lines, as in the for-
that the bound ions of a molecule separate, creating a mula for oxygen; this represents two pairs of shared
solution of free positive and negative ions. For exam- electrons.
ple, if sodium chloride is put in water, it dissolves, then
ionizes. The water now contains Naϩ ions and ClϪ The element carbon always forms covalent bonds;
ions. Ionization, also called dissociation, is important an atom of carbon has four electrons to share with
to living organisms because once dissociated, the ions other atoms. If these four electrons are shared with
are free to take part in other chemical reactions within four atoms of hydrogen, each sharing its one electron,
the body. Cells in the stomach lining produce a molecule of methane gas (CH4) is formed. Carbon
hydrochloric acid (HCl) and must have ClϪ ions to do may form covalent bonds with other carbons, hydro-
so. The chloride in NaCl would not be free to take gen, oxygen, nitrogen, or other elements. Organic

Copyright © 2007 by F. A. Davis. = Some Basic Chemistry 27
O+O
O2 O=O
A
8+ 8+
8+ + 8+ =

O+ H+H = H2O O
HH

1+ 1+
1+

B

8+ + =

1+
8+

Figure 2–3. Formation of covalent bonds. (A) Two atoms of oxygen share two electrons
each, forming a molecule of oxygen gas. (B) An atom of oxygen shares one electron with
each of two hydrogen atoms, each sharing its electron. A molecule of water is formed.
QUESTION: Which of the bonds shown here is a double covalent bond?

compounds such as proteins and carbohydrates are hydrogen bonds. Disulfide bonds are found in some
complex and precise arrangements of these atoms proteins. Hydrogen bonds are part of many different
covalently bonded to one another. Covalent bonds are molecules.
relatively strong and are not weakened in an aqueous
solution. This is important because the proteins pro- A disulfide bond (also called a disulfide bridge) is a
duced by the body, for example, must remain intact in covalent bond formed between two atoms of sulfur,
order to function properly in the water of our cells and usually within the same large protein molecule. The
blood. The functions of organic compounds will be hormone insulin, for example, is a protein that must
considered later in this chapter. have a very specific three-dimensional shape in order
to function properly to regulate the blood glucose
DISULFIDE BONDS AND level. Each molecule of insulin has two disulfide bonds
HYDROGEN BONDS that help maintain its proper shape and function (see
Box Fig. 10–A). Other proteins with shapes that
Two other types of bonds that are important to depend upon disulfide bonds are antibodies of the
the chemistry of the body are disulfide bonds and immune system (see Fig. 14–8) and keratin of the skin
and hair.

Copyright © 2007 by F. A. Davis.

28 Some Basic Chemistry

A strand of hair maintains its shape (a genetic char- In a decomposition reaction, bonds are broken,
acteristic) because of disulfide bonds. When naturally and a large molecule is changed to two or more
curly hair is straightened, the disulfide bonds in the smaller ones. One example is the digestion of large
keratin molecules are broken. When naturally straight molecules of starch into many smaller glucose mole-
hair is “permed” or curled, the disulfide bonds in the cules. Some decomposition reactions release energy;
keratin are first broken, then re-formed in the curled this is described in a later section on cell respiration.
hair. Neither process affects the living part of the hair,
the hair root, so the hair will grow out in its original In this and future chapters, keep in mind that the
shape. We would not want such a process affecting our term reaction refers to the making or breaking of
insulin or antibody molecules, for that would destroy chemical bonds and thus to changes in the physical
their functioning. and chemical characteristics of the molecules
involved.
A hydrogen bond does not involve the sharing or
exchange of electrons, but rather results because of a INORGANIC COMPOUNDS
property of hydrogen atoms. When a hydrogen atom OF IMPORTANCE
shares its one electron in a covalent bond with another
atom, its proton has a slight positive charge and may Inorganic compounds are usually simple molecules
then be attracted to a nearby oxygen or nitrogen atom, that often consist of only one or two different ele-
which has a slight negative charge. ments. Despite their simplicity, however, some inor-
ganic compounds are essential to normal structure and
Although they are weak bonds, hydrogen bonds are functioning of the body.
important in several ways. Large organic molecules
such as proteins and DNA have very specific functions WATER
that depend upon their three-dimensional shapes. The
shapes of these molecules, so crucial to their proper Water makes up 60% to 75% of the human body, and
functioning, are often maintained by hydrogen bonds. is essential to life for several reasons:

Hydrogen bonds also make water cohesive; that is, 1. Water is a solvent; that is, many substances (called
each water molecule is attracted to nearby water mol- solutes) can dissolve in water. Nutrients such as
ecules. Such cohesiveness can be seen if water is glucose are dissolved in blood plasma (which is
dropped onto clean glass; the surface tension created largely water) to be transported to cells throughout
by the hydrogen bonds makes the water form three- the body. The sense of taste depends upon the sol-
dimensional beads. Within the body, the cohesiveness vent ability of saliva; dissolved food stimulates the
of water helps keep blood a continuous stream as it receptors in taste buds. The excretion of waste
flows within the blood vessels, and keeps tissue fluid products is possible because they are dissolved in
continuous around cells. These hydrogen bonds are the water of urine.
also responsible for the other important characteris-
tics of water, which are discussed in a later section. 2. Water is a lubricant, which prevents friction where
surfaces meet and move. In the digestive tract,
CHEMICAL REACTIONS swallowing depends upon the presence of saliva,
and mucus is a slippery fluid that permits the
A chemical reaction is a change brought about by the smooth passage of food through the intestines.
formation or breaking of chemical bonds. Two general Synovial fluid within joint cavities prevents friction
types of reactions are synthesis reactions and decom- as bones move.
position reactions.
3. Water changes temperature slowly. Water has a high
In a synthesis reaction, bonds are formed to join heat capacity, which means that it will absorb a
two or more atoms or molecules to make a new com- great deal of heat before its temperature rises sig-
pound. The production of the protein hemoglobin in nificantly, or it must lose a great deal of heat before
potential red blood cells is an example of a synthesis its temperature drops significantly. This is one of
reaction. Proteins are synthesized by the bonding of the factors that helps the body maintain a constant
many amino acids, their smaller subunits. Synthesis temperature. Water also has a high heat of vapor-
reactions require energy for the formation of bonds. ization, which is important for the process of

Copyright © 2007 by F. A. Davis. Intracellular fluid Some Basic Chemistry 29

Fluid Cell
movement
Capillary
Lymph Lymph
Interstitial capillary
(tissue) fluid
Plasma

Figure 2–4. Water compartments, showing the names water is given in its different loca-
tions and the ways in which water moves between compartments.
QUESTION: Which of the fluids shown are extracellular fluids?

sweating. Excess body heat evaporates sweat on the the body and the functions of the specialized fluids
skin surfaces, rather than overheating the body’s will be discussed in later chapters.
cells, and because of water’s high heat of vaporiza-
tion, a great deal of heat can be given off with the OXYGEN
loss of a relatively small amount of water.
Oxygen in the form of a gas (O2) is approximately
WATER COMPARTMENTS 21% of the atmosphere, which we inhale. We all know
that without oxygen we wouldn’t survive very long,
All water within the body is continually moving, but but exactly what does it do? Oxygen is important to us
water is given different names when it is in specific because it is essential for a process called cell respira-
body locations, which are called compartments (Fig. tion, in which cells break down simple nutrients such
2–4). as glucose in order to release energy. The reason we
breathe is to obtain oxygen for cell respiration and to
Intracellular fluid (ICF)—the water within cells; exhale the carbon dioxide produced in cell respiration
about 65% of the total body water (this will be discussed in the next section). Biologically
useful energy that is released by the reactions of cell
Extracellular fluid (ECF)—all the rest of the water respiration is trapped in a molecule called ATP
in the body; about 35% of the total. More specific (adenosine triphosphate). ATP can then be used for
compartments of extracellular fluid include: cellular processes that require energy.
Plasma—water found in blood vessels
Lymph—water found in lymphatic vessels CARBON DIOXIDE
Tissue fluid or interstitial fluid—water found in
the small spaces between cells Carbon dioxide (CO2) is produced by cells as a waste
Specialized fluids—synovial fluid, cerebrospinal product of cell respiration. You may ask why a waste
fluid, aqueous humor in the eye, and others product is considered important. Keep in mind that
“important” does not always mean “beneficial,” but it
The movement of water between compartments in

Copyright © 2007 by F. A. Davis.

30 Some Basic Chemistry

BOX 2–1 BLOOD GASES oxygen falls below the normal range, oxygen will
be administered; if blood carbon dioxide rises
A patient is admitted to the emergency room with above the normal range, blood pH will be corrected
a possible heart attack, and the doctor in charge to prevent serious acidosis.
orders “blood gases.” Another patient hospitalized
with pneumonia has “blood gases” monitored at Damage to the heart may also bring about a
frequent intervals. What are blood gases, and what change in blood gases, especially oxygen. Oxygen
does measurement of them tell us? The blood gases is picked up by red blood cells as they circulate
are oxygen and carbon dioxide, and their levels through lung capillaries; as red blood cells circulate
in arterial blood provide information about the through the body, they release oxygen to tissues.
functioning of the respiratory and circulatory What keeps the blood circulating or moving? The
systems. Arterial blood normally has a high con- pumping of the heart.
centration of oxygen and a low concentration of
carbon dioxide. These levels are maintained by A mild heart attack, when heart failure is unlikely,
gas exchange in the lungs and by the proper circu- is often characterized by a blood oxygen level that
lation of blood. is low but still within normal limits. A more severe
heart attack that seriously impairs the pumping of
A pulmonary disease such as pneumonia inter- the heart will decrease the blood oxygen level to
feres with efficient gas exchange in the lungs. As a less than normal. This condition is called hypoxia,
result, blood oxygen concentration may decrease, which means that too little oxygen is reaching tis-
and blood carbon dioxide concentration may sues. When this is determined by measurement of
increase. Either of these changes in blood gases blood gases, appropriate oxygen therapy can be
may become life threatening for the patient, so started to correct the hypoxia.
monitoring of blood gases is important. If blood

does mean “significant.” If the amount of carbon di- carbon dioxide and water. The potential energy in the
oxide in the body fluids increases, it causes these fluids glucose molecule is released in two forms: ATP and
to become too acidic. Therefore, carbon dioxide must heat. Each of the four products of this process has a
be exhaled as rapidly as it is formed to keep the purpose or significance in the body. The carbon diox-
amount in the body within normal limits. Normally ide is a waste product that moves from the cells into
this is just what happens, but severe pulmonary dis- the blood to be carried to the lungs and eventually
eases such as pneumonia or emphysema decrease gas exhaled. The water formed is useful and becomes part
exchange in the lungs and permit carbon dioxide to of the intracellular fluid. The heat produced con-
accumulate in the blood. When this happens, a person tributes to normal body temperature. ATP is used for
is said to be in a state of acidosis, which may seriously cell processes such as mitosis, protein synthesis, and
disrupt body functioning (see the sections on pH and muscle contraction, all of which require energy and
enzymes later in this chapter; see also Box 2–1: Blood will be discussed a bit further on in the text.
Gases).
We will also return to cell respiration in later chap-
CELL RESPIRATION ters. For now, the brief description just given will suf-
fice to show that eating and breathing are interrelated;
Cell respiration is the name for energy production both are essential for energy production.
within cells and involves both respiratory gases, oxy-
gen and carbon dioxide. Many chemical reactions are TRACE ELEMENTS
involved, but in its simplest form, cell respiration may
be summarized by the following equation: Trace elements are those that are needed by the body
in very small amounts. When they are present in food
Glucose (C6H12O6) ϩ 6O2 → 6CO2 ϩ 6H2O ϩ ATP ϩ heat or nutritional supplements, we often call them miner-
als, and examples are iron, cobalt, and zinc. Although
This reaction shows us that glucose and oxygen they may not be as abundant in the body as are carbon,
combine to yield carbon dioxide, water, ATP, and heat. hydrogen, or oxygen, they are nonetheless essential.
Food, represented here by glucose, in the presence of Table 2–2 lists some of these trace elements and their
oxygen is broken down into the simpler molecules functions (see also Box 2–2: Nitric Oxide).

Copyright © 2007 by F. A. Davis.

Some Basic Chemistry 31

Table 2–2 TRACE ELEMENTS BOX 2–2 NITRIC OXIDE

Element Function Nitric oxide is a gas with the molecular formula
Calcium NO. You have probably heard of it as a compo-
• Provides strength in bones and teeth nent of air pollution and cigarette smoke, but it
Phosphorus • Necessary for blood clotting is synthesized by several human tissues, and
• Necessary for muscle contraction this deceptively simple molecule has important
Iron functions.
• Provides strength in bones and teeth
Copper • Part of DNA, RNA, and ATP Nitric oxide is produced by the endothelium
Sodium and • Part of cell membranes (lining) of blood vessels and promotes vasodila-
tion of arterioles, permitting greater blood flow
potassium • Part of hemoglobin in red blood and oxygen delivery to tissues. It is involved in
Sulfur cells; transports oxygen nerve impulse transmission in the brain, and may
Cobalt contribute to memory storage. Some immune
Iodine • Part of myoglobin in muscles; stores system cells produce nitric oxide as a cytotoxic
oxygen (cell-poisoning) agent to help destroy foreign
cells such as bacteria.
• Necessary for cell respiration
Nitric oxide is also being used therapeutically
• Necessary for cell respiration in clinical trials. It has been found useful in the
• Necessary for hemoglobin synthesis treatment of pulmonary hypertension to relax
abnormally constricted arteries in the lungs to
• Necessary for muscle contraction permit normal gas exchange. Other studies
• Necessary for nerve impulse trans- show that nitric oxide helps some premature
babies breathe more easily and efficiently.
mission
Much more research is needed, including a
• Part of some proteins such as insulin determination of possible harmful side effects of
and keratin greater than normal amounts of nitric oxide, but
the results of some clinical trials thus far are
• Part of vitamin B12 promising.

• Part of thyroid hormones—thyroxine with a pH of 6. Figure 2–5 also shows the pH of some
body fluids and other familiar solutions. Notice that
ACIDS, BASES, AND pH gastric juice has a pH of 1 and coffee has a pH of 5.
This means that gastric juice has 10,000 times as many
An acid may be defined as a substance that increases Hϩ ions as does coffee. Although coffee is acidic, it is
the concentration of hydrogen ions (Hϩ) in a water a weak acid and does not have the corrosive effect of
solution. A base is a substance that decreases the con- gastric juice, a strong acid.
centration of Hϩ ions, which, in the case of water, has
the same effect as increasing the concentration of The cells and internal fluids of the human body
hydroxyl ions (OHϪ). have a pH close to neutral. The pH of intracellular
fluid is around 6.8, and the normal pH range of blood
The acidity or alkalinity (basicity) of a solution is is 7.35 to 7.45. Fluids such as gastric juice and urine
measured on a scale of values called pH (parts hydro- are technically external fluids, because they are in
gen). The values on the pH scale range from 0 to 14, body tracts that open to the environment. The pH of
with 0 indicating the most acidic level and 14 the most these fluids may be more strongly acidic or alkaline
alkaline. A solution with a pH of 7 is neutral because without harm to the body.
it contains the same number of Hϩ ions and OHϪ
ions. Pure water has a pH of 7. A solution with a The pH of blood, however, must be maintained
higher concentration of Hϩ ions than OHϪ ions is an within its very narrow, slightly alkaline range. A
acidic solution with a pH below 7. An alkaline solu- decrease of only one pH unit, which is 10 times as
tion, therefore, has a higher concentration of OHϪ many Hϩ ions, would disrupt the chemical reactions
ions than Hϩ ions and has a pH above 7. of the blood and cause the death of the individual.
Normal metabolism tends to make body fluids more
The pH scale, with the relative concentrations
of Hϩ ions and OHϪ ions, is shown in Fig. 2–5. A
change of one pH unit is a 10-fold change in Hϩ ion
concentration. This means that a solution with a pH
of 4 has 10 times as many Hϩ ions as a solution with a
pH of 5, and 100 times as many Hϩ ions as a solution

Copyright © 2007 by F. A. Davis.

32 Some Basic Chemistry

Figure 2–5. The pH scale. The pH values of several body fluids are indicated above the
scale. The pH values of some familiar solutions are indicated below the scale.
QUESTION: Describe the pH range of blood compared to the pH range of urine.

acidic, and this tendency to acidosis must be continu- As a specific example, we will use the bicarbonate
ally corrected. Normal pH of internal fluids is main- buffer system, which consists of carbonic acid
tained by the kidneys, respiratory system, and buffer (H2CO3), a weak acid, and sodium bicarbonate
systems. Although acid–base balance will be a major (NaHCO3), a weak base. This pair of chemicals is
topic of Chapter 19, we will briefly mention buffer present in all body fluids but is especially important to
systems here. buffer blood and tissue fluid.

Buffer Systems Carbonic acid ionizes as follows (but remember,
because it is a weak acid it does not contribute many
A buffer system is a chemical or pair of chemicals Hϩ ions to a solution):
that minimizes changes in pH by reacting with strong
acids or strong bases to transform them into sub- H2CO3 → Hϩ ϩ HCO3Ϫ
stances that will not drastically change pH. Expressed
in another way, a buffer may bond to Hϩ ions when a Sodium bicarbonate ionizes as follows:
body fluid is becoming too acidic, or release Hϩ ions
when a fluid is becoming too alkaline. NaHCO3 → Naϩ ϩ HCO3Ϫ

If a strong acid, such as HCl, is added to extracel-
lular fluid, this reaction will occur: